Organization
MOHANSIC DIALYSIS, LLC
Active
Other names
Fort Belvoir Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
8123 RICHMOND HWY, ALEXANDRIA, VA 22309-3613
(703) 619-3801
(703) 619-3805
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 320-4214
(866) 944-3352
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
02/22/2019
Last updated
01/08/2024
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